Baptist Health Hospitals

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

BAPTIST HEALTH HOSPITALS

Practice address

221 NE 2ND St
England, AR 72046-1803

Phone

(501) 842-3819

NPI assigned

Apr 29, 2014

Last updated

Sep 15, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Troy Wells

Title

President

Phone

(505) 202-2080

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164832184. Details of each certification follow.

• CCN 048505 Rural health clinic · Active · Details

Rural health clinic certification: CCN 048505

Legal name

BAPTIST HEALTH HOSPITALS

Doing business as

BAPTIST HEALTH STUTTGART CAMPUS CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Feb 26, 2014

Last certification

May 31, 2023

Ownership / control type

2B

Organization structure

CorporationNon-profit

Incorporated

Sep 1, 2008 in AR

Enrollment address

1703 N Buerkle St
Ste 2
Stuttgart, AR 72160-3153

Related CCNs

040072

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Baptist Health Hospitals

  dba Baptist Health Stuttgart Campus Clinic

  • Rural Health Clinic/Center
  • Stuttgart, AR
  • NPI 1447688585

  O20131219000069

  Same enrollment

Locations

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1164832184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1901",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "721601901",
            "telephone_number": "870-673-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE 2ND ST",
            "city": "ENGLAND",
            "state": "AR",
            "postal_code": "720461803",
            "telephone_number": "501-842-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-202-2080"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203673729",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arcare (ARcare Pharmacy 11)
• Arcare (ARcare 18)
• Arcare (ARcare 11)
• Arkansas Health Group (Baptist Health Family Clinic-England)
• Azuree's Heart LLC
• Dwayne Brewer, CMP
• Lenora Brooks, CMP
• Tenille Brooks, CMP
• Deon Brown, CMP
• Mallory Bynum

• Rural Health Clinic/Center in England, AR
• Providers in England, AR by specialty
• Rural Health Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.